Types of Spinal Cord Injury and the Extent of Mobility
3 Minute Read from Hamilton Spinal Cord Injury Lawyers
SCI remains a devastating condition affecting all age group engaged in life-enjoying activities. Those with severe injuries usually have significant, permanent neurological and psychological deficits with which they must live for the rest of their lives. Spinal cord injury is a devastating event for which we have yet to find a cure. SCI requires a lifelong commitment to rehabilitation and adaptation to acquired disabilities. The following is a summary of complete & incomplete SCI Ontario injuries as a well as a summary of the extent of mobility from a course we recently attended.
A Complete Spinal Cord Injury
With complete spinal cord injuries victims suffering have no preservation of motor and sensory function. It is an injury that is absolute and causes the complete loss to send impulses from the brain to damaged sections of the spinal cord below the level of injury. With complete injuries, the spinal cord normally goes into spinal shock after it has been damaged. These victims are defined medically as ASIA A. Complete SCI above the 3rd cervical vertebrae level can result in death from respiratory failure without immediate intervention with cardiopulmonary resuscitation (CPR) and may require a ventilator for breathing.
Victims with complete SCI can also develop loss of autonomic function. Your body’s autonomous functions are regulated “unconsciously” such as breathing, your heart rate, digestions ect. Complete spinal cord injury can also cause bowel and bladder dysfunction with incontinence. Unfortunately, with a complete SCI (and unlike an incomplete SCI), very few victims with complete SCI will recover meaningful neurological function.
An Incomplete Spinal Cord Injury
An incomplete spinal cord injury means that messages from the brain to segments of the spinal cord are not completely lost and there is some preservation of movement and sensation, even though it may be faint. Victims with incomplete SCI can be classified in syndromes based on correlation of spinal cord anatomy and presenting symptoms. Spinal Cord victims that are left with any residual motor or sensory function below the level of injury in the spinal cord are considered incomplete spinal cord fractures, which often means more preserved functions such as sexual function and perhaps bowels and bladder function. Self-care and mobility is more manageable than those who suffer a complete spinal cord injury. Other signs of preserved function also include sensation or voluntary movement in the legs, feet and toes and voluntary rectal sphincter contraction.
A common type of incomplete SCI is Central Cord Syndrome (CCS). This is usually caused by trauma or damage to the neck, leading to injury in the grey matter of the spinal cord. It usually happens in younger people and it may occur following severe high-energy, high-velocity spinal column type trauma. Some other common forms of incomplete SCI syndromes include central cord syndrome, Brown-Séquard syndrome, anterior and posterior cord syndrome, conus syndrome, and cauda equina syndrome.
Some Mobility Indicators at Various Levels of Spinal Cord Injury
L2 to S5 Paraplegia
Victims that suffer paraplegia in the L2 to S5 (lower back) region can sometimes stand independently. The majority of spinal cord injury victims with injuries at the L2 to S5 will be community ambulators, although knee, ankle and foot orthoses may be necessary. Knee-ankle-foot orthoses are braces which address dysfunction at the ankle and knee together. Ambulatory devices like crutches, or a cane may also be needed. Independent transfers into and out of the car are possible, and the ability to drive independently may be but may need hand controls depending on level of injury.
Victims that suffer paraplegia in the T10 to L1 regions are able to stand independently with knee-ankle-foot orthoses (KAFOs) or a standing frame. Ambulation for exercise may be independent or require some assistance crutches or a walker and KAFOs usually are needed. The primary mode of locomotion remains a manual wheelchair. Victims are normally independent for transfers into and out of a car, and are able to drive independently with hand controls. Most are independent for bed mobility, independent for all transfers including floor to chair transfers, they are able to propel a manual wheelchair in the community, pop a “wheelie” and ascending curbs.
T1 to T9 Paraplegia
The majority of spinal cord victims are not able to ambulate functionally due to energy expenditure needs. Most are able to ambulate with long leg braces and walker or crutches for exercise and independent for transfers into and out of a car with either a sliding board or popover technique. Most victims are able to drive with hand controls, can maintain floor to chair transfers, and can propel a wheelchair in the community.
Most victims that are C8 Tetraplegic are independent with driving in a car with modified controls or a van with a captain’s seat, independent for bed mobility, independent with transfers, independent with wheelchair propulsion with power or manual wheelchair although an ultralight wheelchair or power-assist wheelchair is preferred
Victims that suffer from C4 Tetraplegia need total assistance needed for transportation in an accessible van or public transportation. They require total assistance for bed mobility and wheelchair and bed transfers. Most victims are independent with power wheelchair propulsion with an appropriate control device such as a sip-and-puff control or head array. They are unable to propel a manual wheelchair.
Victims that suffer from C1-C3 Tetraplegia require total assistance for transportation in an accessible van or public transportation, bed mobility, and wheelchair or bed transfers. Total assistance is also needed for bed mobility and ventilation is often required.
Spinal Cord Injury Ontario
Having a spinal cord injury (SCI) can profoundly change an accident victim’s life as it can affect nearly all the body systems. It also affects the perception of that person by others. At Lalande & Company Lawyers, we are Hamilton Spinal Cord Injury Lawyers dedicated to helping those affected to return to a productive life integrated within society. If you or a loved one has suffered a spinal cord injury anywhere in Ontario, our Hamilton are happy to help with obtaining the financial assistance and future care required in order to comfort or reintegrate you into the community. Please contact us at 905-333-8888 or by filling out a contact form, by speaking with our live operator who will be able to set up an appointment with you as soon as possible.